Influence of nonalcoholic fatty liver disease on the therapeutic effect of nucleoside(acid)analogs for hepatitis B virus  

作　　者：Hua-Dong Li Ya-Nan Liu Shuang Wu Xu-Feng Quan Xiao-Yan Wang Tian-Dan Xiang Shu-Meng Li Ling Xu Tong Wang Hua Wang Xin Zheng 

机构地区：[1]Department of Infectious Diseases,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,Hubei Province,China [2]Department of Infectious Diseases,Wuhan Jinyintan Hospital,Wuhan 430023,Hubei Province,China

出　　处：《World Journal of Hepatology》2024年第12期1395-1406,共12页世界肝病学杂志（英文）

基　　金：Supported by National Science and Technology Major Project of China,No.92169121;National Key R and D Projects,No.2022YFC2305100;Wuhan Science and Technology Bureau Knowledge Innovation Special Foundation of Hubei Province,No.2022020801010588.

摘　　要：BACKGROUND The effect of nonalcoholic fatty liver disease(NAFLD)on the efficacy of nucleoside analogues(NAs)in antiviral therapy for patients with chronic hepatitis B(CHB)remains controversial.AIM To investigate the influence of NAFLD on virological response in CHB patients undergoing NAs treatment.METHODS Logistic regression analysis was conducted on a cohort of 465 CHB patients from two hospitals to determine whether NAFLD was a risk factor for adverse reactions to NAs.CHB patients were followed up for more than 28 months after initial antiviral treatment,and further validation was performed using different viral load populations.RESULTS NAFLD was identified as an independent risk factor for partial virological response following antiviral therapy with NAs(odds ratio=1.777,P=0.017).In our subsequent analysis focusing on CHB patients with high viral load,the NAFLD group exhibited significantly longer virus shedding time and lower proportion of the complete virological response compared with the non-NAFLD group(16.8±6.1 vs 13.0±6.8,P<0.05).During the 24-month period of antiviral treatment with NAs,hepatitis B virus(HBV)DNA levels decreased slowly in the NAFLD group,and the negative conversion rate of HBV was notably lower than that observed in non-NAFLD group(P=0.001).Similar results were obtained when analyzing patients with low baseline HBV viral load within the NAFLD group.CONCLUSION Coexistence of NAFLD may diminish virological response among CHB patients receiving antiviral treatment with NAs.

关 键 词：Nonalcoholic fatty liver disease Chronic hepatitis B Nucleoside analogues Antiviral therapy Virological response 

分 类 号：R512.62[医药卫生—内科学] R575.5[医药卫生—临床医学]